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My sister is the primary caregiver. I live abroad. My parents lived in France. My father had a stroke last year and subsequently we moved him to a home back in the UK where he is from and where my sister lives. My mother passed unexpectedly in December. It has been a very tough year for us all. I live in California - I traveled to France to help with our parents several times last year and spent about 2 months total there. I have a young son - so does my sister, and she actually spent double that time in France caring for our parents, being closer. She doesn't work, I do and I'm the primary breadwinner in my family as my husband is out of work. Now that my mother is no longer around and my father has been moved close to my sister, she cannot cope with the paperwork and the daily visits to him - she has depression. She is also very resentful and angry with me for being so far away and recently demanded I move back to the UK to help with our father. I don't know what to do. Moving back to the UK after living in the US for 15 years is no easy task and I don't have the financial stability to be able to make that work. I feel helpless. My father has vascular dementia and is rapidly going downhill. I have suggested to my sister that she needs to take a break and take some time for herself but she says it makes it worse with my father who cries when she doesn't visit. We installed him in a very good care home - but the guilt is overwhelming.

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Dear sfad11,

I can sympathize and empathize that you are in a very difficult situation. And its not easy on either you or your sister. I can barely imagine moving from one house to another in the same city so moving from the USA back to UK is a big consideration.

I am glad you are trying to help your sister and can see her point of view as well. I can see why your sister in the UK wants you to move back home. As the sibling that did remain home and did most to all of the caregiving for her parents. There is a lot of anger and resentment about the burden and responsibility. And it can contribute to depression in the caregiver or make it worse.

If you can continue to let your sister know that you love her and care about her. And as much as you would like to move its not financially feasible right now. Ask her what she wants? What other options are there? More home care? Counseling? Support groups? Help from a local church?

I know its not easy for your dad either. He is probably afraid and lonely. But at the same time, your sister cannot succumb to guilt. She has to take care of herself as well. I hope there are other family members or friends that could visit him more as well.
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I empathize. I suffer from depression and even though we have made progress as a society recognizing that it is a disease, there are still those who like to point fingers and criticize, say we are weak, lazy, under-achievers etc., etc. When you feel so low that even getting up off the couch to put the kettle on seems like an overwhelming task, it doesn't help to have people looking at you skeptically.

I say ignore the naysayers and try to find supportive people in your life. Even just coming on here is a good start. There are so many good, kind, empathetic people on here. There are a few douchebags too but just ignore them.
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PS.. I didn't mention brothers. I have two. They weren't worth mentioning because they only made things harder for me...even the one who actually LIVED THERE WITH MOM. Now I have a section of my big loving "TV sitcom perfect family" who no longer speak to me. I can only question why...but I suppose they think I should've moved mom into my home. I tried that for a month. I literally fell apart a week after mom insisted on going home, even though my husband and I bent over backwards to make her stay welcoming by changing my sewing room into a special bedroom for mom with family photographs on the walls and outfitting bathrooms to accommodate her, etc. So - why do i still feel guilty???? I have started counseling.
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I've been a caregiver and agree with "scaredtaker". I also suffer from depression and anxiety, take medications for it and struggle with a great deal of self-doubt over choices made regarding my mother's care. She was moved to assisted living last summer resulting in the first holiday season without our parents/grandparents home as the focal point of our very large family's celebrations. My father died about 5 years ago. After that we still all met at Mom's. Even when it became too hard for mom to do all the cooking, we brought food in order to continue traditions, with me (as the eldest daughter) bringing everything but the kitchen sink. I live 2 hours away, am 60 years old and have numerous health problems including a spine injury. As Mom's memory gave out, it was up to me to make that 2 hour trip several times a week, until I felt more frazzled than an old worn down scrub-brush with hardly any bristles left. My 11 year younger sister works full time and although unable to do much physically, was not only my sounding board but also a loving, concerned, fully attentive listener. She helped me to take a deep breath. Then she would present a logical new perspective if she felt I was able to soak up anything. If *NOT*, she would simply say I love you sis... in the most gentle sweet voice... which always lifted my spirit. These talks (or texts) were almost never in person since she was usually working ...and I was either with mom or driving.... OR sometimes crying in my car, parked in an empty lot late at night, too burned out to continue driving.
My sister saved my LIFE.
One other thing she could do from a dicontinuegot me a gift card for a massage!! Then she'd sit with mom while I made use of that treasured gift.
I hope others in the position of trying to support the primary caregiver will use these suggestions. If it's a male caregiver, perhaps just give him the gift of some time to himself. Knowing mom (or dad) is in good loving hands while taking a much-needed and well-deserved break is the ultimate gift.
One more point.. Thus past 2 months I've been suffering from symptoms commonly linked to "PTSD". I have read articles about this topic. There is debate as to whether it is a "real" thing. I believe it is and that it can happen either while being a caregiver or afterwards. If anyone else is experiencing this, I would appreciate hearing from you.
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PS I dont mean you should feel guilt when I typed that you should believe your sisters truth. I meant the truth of what she is experiencing w dad. Guilt is an awful cross to bear and I don't recommend it.
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Your sister is overwhelmed from caregiving and I completely understand. Having a front row seat to the physical & mental decline of once able-bodied, capable parents is tough even on the toughest. She is frustrated and it is a cry for help. People tell caregivers to ak for help and many times those pleas are ignored by the system resources failing or family unable or unwilling to truly help in a consistent, meaningful way.
Therapy is one way for her to vent and perhaps access assistance for herself and she must do it to save her own life. Whatever you are able to do by way of helping, please do. And know you are doing your best with what you have where you are.
It is so hard - especially at such great distance!
My two siblings who speak to me are far and rarely want to hear anything about my parents from my end of reality - yet they start the convo by trashing the work I have do do alone without help of closer by siblings. Ironic. Still the same net affect. So I am basically shut down if I speak about how my parents are doing much less me. They don't send cards or even text back most times. Its painful. I tried telling them we are close to the end with mom and they should visit but their own guilt and denial allows them freedom from pitching in.
I can say I would appreciate respite or visits from the two I am on ok terms with and the cease and desist of the other two who are spearheading a smear campaign to anyone who will listen. As a caretaker I think we want to have respect & appreciation - and many families have that - not mine. I am the scapegoat which sets me up to be a failure no matter what I do. I am growing a stronger sense of self trough reclaiming my life and worth through my own hard ass work w therapy and getting out before I give up on myself. That is the danger of depression! If the work is not done and she does not get relief, it will only grow and possibly rob her life. My family would not give a turd if it were me - but yours sounds like a good but overwhelmed fam.

Your dad may wellb e crying I would not doubt her information. Please accept what she is saying is the truth. Doubting her will only keep you from helping any way you can as well as adding to her experience as a caregiver. We are told to ask for help and in my situation I have asked subtly then more directly because it was overwhelming. WRONG MOVE in my fam. I was yelled at, told to suck it up and called a loser. Nothing will make a person want to give up more than to endure abuse be it emotional or physical. The awful thing about emotional is being called a liar and a big baby - the scars are real but because they are inside the physical body, people often do not believe the truth teller. Some emotionally bereft caregivers can end up hurting themselves because nobody will help as in my case.
Your dad may well cry - I would if I were in his shoes. It's scary, difficult & extremely frustrating to be in less capable situations and the loss of autonomy and independence. Our healthcare system HERE is really crappy in terms of resources and studies on elderly. We can keep people around long past the traditionally former expiry dates before medicine improved - and then wonder why we have a huge population of elderly people and pissed of caregivers who are burned out.
Whenever I read about an elderly person crying because they are sad it tears me up because I can completely understand their pain and depression. It is real in the elderly as it is in caregivers. The older we get the more we want our comfort zone. But this comfort zone cannot sustain itself as we age and the elderly have trouble adapting to change especially with dementia and the knowledge that the end of their life is coming. I would want my comfort zone when I am close to passing away.
Its not easy no matter which side of the coin a person is on.
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Your sister blaming you is preposterous, but bear in mind that she currently has a mental health problem, and try not to take this too personally.

Depression is a serious condition. Fortunately it is treatable. What is your sister doing to treat hers? She needs to take care of herself, but it can be very hard to take the initiative when you are depressed. She needs to get enough sleep. She needs to get some exercise. She needs to eat regularly and it needs to be (at least some of time) reasonably healthy food.

Is there anything you can do to encourage her to do these things? Without sounding bossy or condescending?

She has been diagnosed. It is great that she is discussing this with a doctor. Did the doctor prescribe antidepressants? Counseling? A referral to a specialist? Again, is there any way you can encourage her to comply with the doctor's treatment plan? Most antidepressants take several weeks to reach maximum effectiveness. Help her hang in there!

She says Dad cries if she doesn't visit. How does she know that? He may fuss when she says "I'll see you in a couple of days," but does he really cry the next day? Does he even remember when she was there? He is in a good care center and they know how to calm people with depression. She really needs to cut back on her visits, at least until her depression is well-managed.

So, first, your sister has to treat her very real impairment now. Most of the advice I've given is for her.

I've been diagnosed with major depressive disorder. Most of the time it is pretty well managed but I have occasional episodes where it gets severe enough to interfere with daily functioning. My sisters and my best friend really help me through those episodes. First, they accept that it is a real medical condition. All of their comments about it are encouraging. They don't nag but they do gently remind me to take care of myself. "Did you get a chance to walk outside today?" They are sympathetic but they discourage long-term pity parties. They praise me a lot. They do most of this via email. We don't live close enough together for drop-in-for-coffee visiting.

And as for your feelings, regret and sadness and empathy are very understandable. But guilt? Your father's stroke was Not Your Fault. That he developed dementia was Not Your Fault. That your sister is having a tough time right now is Not Your Fault. That you need to support your family financially right now is Not Your Fault. In other words, you haven't earned any guilt so please don't claim it!

Send cards and pictures to your father. Be emotionally supportive of your sister. Don't be burdened by unearned guilt!
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Sending cash or even a care box of American junk food may brighten her day a little.

I agree with encouraging her for diet and exercise. Just be careful how you word it. It may make her more stressed if said the wrong way.
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Is sister going through menopause? This can make her depressed as well, so encourage her to get a good physical and proper diet and exercise.
You do not need to move. She needs to take care of herself first and foremost.
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